I have a patient who has his pd catheter for over 1 year, but has not needed dialysis yet. The catheter was being flushed once every 2-3 weeks with 1000ml of Dianeal and after the flush heparin was instilled before capping off. The catheter functioned well until two months ago. Abdominal xray was done and the catheter migrated out of the pelvis. The catheter was surgically repositioned and it is work fine again. Is there a better way to maintain this catheter, the patient still doesnot need dialysis and not sure when dialysis will be started. The patient's creatinine has been in the 3's for over a year.

Questions About PD

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Liz,S, Nurse from New York asked
I have a patient who has his pd catheter for over 1 year, but has not needed dialysis yet. The catheter was being flushed once every 2-3 weeks with 1000ml of Dianeal and after the flush heparin was instilled before capping off. The catheter functioned well until two months ago. Abdominal xray was done and the catheter migrated out of the pelvis. The catheter was surgically repositioned and it is work fine again. Is there a better way to maintain this catheter, the patient still doesnot need dialysis and not sure when dialysis will be started. The patient's creatinine has been in the 3's for over a year.

1 answer

There is no real answer to this as firstly there is no evdience that flushing will prevent blockage or migration. We have used catheters after one year and not flushed them. I would suggest that you ensure the patient is aware of preventing constipation as this is most likley to cause migration. Perhaps mild laxatives may need to be used until it is needed to be used.

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